“This article discussed the importance of the NHS Open Dialogue Training underpinning the holistic approach we wish to promote in the new Open Dialogue Service in Kent.”
On a personal level I was contacted 2 weeks ago by a friend whose child was experiencing mental health issues, the friend knows I have completed the Open Dialogue training and is aware of Open Dialogue as a Family Therapy approach. The friend felt their family was in a state of crisis and had no support and was wondering if I could use my influence to obtain a referral into the Open Dialogue Service.
The child lives 70 miles from his mother and has apparently experienced problems in the past and she had an inkling that things were not well as she had recently visited her. The daughter had been arrested and kept overnight by the police who suspected her of being drunk and charged her with possession of cannabis. My friend had driven to the police station and picked her up and brought her reluctantly home. A family alteraction arose between the daughter , her parents and siblings and my friend began to realise how unwell her daughter was and that maybe they needed professional help as a family and that the family could not help the situation. My friend is a well-educated, middle class, professional woman well used to managing difficult situations as is her husband who has an equally challenging job, the children of the marriage are in their twenties and thirties and responsible adults. This was therefore a family ostensibly well equipped to manage a psychotic crisis brought on by substance misuse, but were unable to cope.
I suggested as things became increasingly unmanageable with escalating family rows and the departure of the daughter into the local main town in an extremely distressed psychological state that a phone call be made to the local mental health service, emergency weekend number .My friend was fearful of her daughter being hurt or arrested by the police. The mental health professional who spent time talking to my friend stated that nothing could be done unless the daughter made contact with the service. As the daughter was extremely, psychologically unwell by now and was experiencing what was probably a psychotic episode she was highly unlikely to be contacting the mental health team . My friend was distraught fearing for her daughter and her family and extremely distressed by the level of criticism levelled at both herself and her husband by her daughter.
I received further messages and phone calls as the situation escalated but was aware that because of restrictions in relation to age, diagnosis and area that her daughter would be unable to access the new Open Dialogue Service in Kent. I was also only too aware that apart from Dialogue First and the Open Dialogue training service run by Nick Putman there were no other options. Neither Dialogue First or the Open Dialogue service see clients who are in crisis as they do not have the staff or facilities.
I was left feeling that although we in Kent are attempting to put in place this service that replicates the Finnish Open Dialogue service we have a long way to go both locally and nationally to provide appropriate services for individuals and their family network at a point of crisis.
Author Bio: Jane Hetherington, Principal Psychotherapist at KMPT and an employee at Early Intervention Services in Kent, has completed Open Dialogue course and will be a part of the new Open Dialogue service. She is trained as an integrative psychotherapist and has experience working in primary care, substance misuse, and psychosis services. Here, she writes about a few psychotherapeutic theories.
